Provider Demographics
NPI:1780673467
Name:THRONSON, FREDDIE EUGENE JR (ARNP)
Entity Type:Individual
Prefix:MR
First Name:FREDDIE
Middle Name:EUGENE
Last Name:THRONSON
Suffix:JR
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6000 W HIGHWAY 98
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32512-0001
Mailing Address - Country:US
Mailing Address - Phone:850-505-6601
Mailing Address - Fax:850-505-6608
Practice Address - Street 1:6000 W HIGHWAY 98 NAVY HOSPITAL FAMILY MED GOLD
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32512-0001
Practice Address - Country:US
Practice Address - Phone:850-505-6601
Practice Address - Fax:850-505-6608
Is Sole Proprietor?:No
Enumeration Date:2005-10-17
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2635022363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
P65496Medicare UPIN
FLP65496Medicare ID - Type Unspecified
FL30508310030Medicaid